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Virginia Affordable Care Act

Virginia Affordable Care Act Guide

In this informative article, you will learn about the Affordable Care Act health care reform laws in Virginia.  You will learn how the new health care reform law, Affordable Care Act, also known as Obamacare or ACA, impacts you as a citizen of the state.  Learn how to sign-up for Virginia Affordable Care Act, the Affordable Care Act penalty, and subsidies.

What is Virginia Affordable Care Act?

Affordable Care Act, also know as ObamaCare or Health Care Reform was signed into law in March 2010.  There are four main goals of the Affordable Care Act:

  1. Expanding Health Care Insurance Coverage
  2. Providing New Consumer Insurance Protections
  3. Offering New Insurance Choices via Marketplace Exchanges
  4. Making Health Insurance more affordable

When can I apply for the Affordable Care Act Virginia?

You can only apply for Virginia Affordable Care Act during Open Enrollment.  The open enrollment for Virginia  Affordable Care Act is usually from November 1 to December 15.

If you qualify for Virginia Medicaid health insurance, then you can sign-up for Medicaid any time of the year.

If there are life-changing events, then you can apply for the Affordable Care Act Special Enrollment Period.

When is the Virginia Affordable Care Act deadline?

The VA Affordable Care Act Open Enrollment is only open for 6 weeks around November and December.  There are two important dates for the Virginia Affordable Care Act:

  • November 1: First day to enroll or change plans for new coverage
  • December 15: Last day to enroll in or change plans for new coverage to start the following year

How do I apply for the Affordable Care Act Virginia (VA ACA)?

Virginia Affordable Care Act Health Insurance Marketplace is run by the Federal government. Click on HealthCare.gov to access Virginia Affordable Care Act Marketplace.  You can preview the different insurance plans and see participating doctors before selecting the final health insurance plan.

How much is the Affordable Care Act Virginia?

The cost of Virginia Affordable Care Act health insurance depends on the metal plan you choose and the number of people in the household.

There are four different health insurance plans within the Virginia Obamacare Marketplace.  All of the plans cover the Essential Health Benefits.  The metal plans represent the various levels of coverage you receive and what the plan pays on average.  The plan levels DO NOT represent the quality of the health coverage/doctors you receive.

  • Bronze Plan: The plan pays 60% of the cost, you pay 40% of the cost
  • Silver Plan: The plan pays 70% of the cost, you pay 30% of the cost
  • Gold Plan: The plan pays 80% of the cost, you pay 20% of the cost
  • Platinum Plan: The plan pays 90% of the cost, you pay 10% of the cost

Platinum plans have the highest insurance premiums (monthly cost) and Bronze plans have the lowest insurance premiums.

How much is Virginia Affordable Care Act Penalty?

The penalty (or also called individual shared responsibility payment) is calculated in two ways.

Starting in the 2019 tax year, there is no longer a penalty for not having health insurance.

From 2016-2018, the ACA penalty is as follows:

  1. By percentage of income (2.5% of household income or a maximum of National Average Bronze plan premium)
  2. By number of people in the household ($695 per adult, $347.50 per child, or maximum $2085)

You’ll pay whichever penalty is higher.

How much are Virginia Affordable Care Act Subsidies? What are the requirements?

If your gross income is between 133% to 400% of the Federal Poverty Level, you can qualify for Affordable Care Act Subsidies if you purchased the health insurance from the Federal/State Marketplace.  Affordable Care Act Subsidies are also called, “Premium Tax Credits or PTC.”  If your income is above 400% of the Federal Poverty Level, you do not qualify for any Affordable Care Act Premium Subsidy.

ACA subsidy lowers your premium – the amount you pay each month to your insurance plan. The amount of your ACA Subsidy depends on the estimated household income that you put on your ACA Marketplace application.

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Do I need to get the Affordable Care Act in Virginia?

Yes, every individual in Virginia needs to have health insurance.  One of the hallmarks of the Affordable Care Act health care reform law is the Individual Mandate.  The Individual Mandate of Affordable Care Act health care law requires US Citizens and legal residents to enroll in a health insurance plan or pay a penalty.

You can choose not to have health insurance, but you will have to pay the penalty in addition to the hospital/doctors medical fee if you do get sick.

You might be able to qualify for health coverage exemptions and be waived from paying the Affordable Care Act penalty.

What is the Requirement for Affordable Care Act Virginia?

To qualify for Virginia Affordable Care Act, you must meet the following requirements:

  • Must live in Virginia
  • Must be a US citizen, national, or lawfully present, immigrant
  • Cannot be currently incarcerated (be in jailed)
  • Have a valid Social Security Number

Medicaid Expansion Relating to Affordable Care Act Virginia

Virginia did not expand the Medicaid program as of 2015/2016.

Virginia Affordable Care Act Frequently Asked Questions:

  1. Who runs the Affordable Care Act Virginia Marketplace? Federal
  2. Where can I sign up for the Affordable Care Act Virginia? Click here
  3. How much is the health insurance premium for Virginia Affordable Care Act? It depends on your income and the number of households/family.
  4. Which insurance companies are offering Affordable Care Act Plans in the state of Virginia? Click here to see the insurance companies

Click here for more Frequently Asked Questions on ACA / Affordable Care Act.

For additional Information on Virginia Affordable Care Act / Obamacare:

Virginia State Corporation Commission
Bureau of Insurance
Tyler Building, 1300 East Main Street
Richmond, Virginia 23219
(800) 552-7945 (Virginia only)
(804)371-9741
http://www.scc.virginia.gov/boi/index.aspx
Bureauofinsurance@scc.virginia.gov

If you have a hard time affording health coverage and you have questions about eligibility or current Medicaid benefits, go to:

Department of Social Services
Division of Benefit Programs
801 East Main Street
Richmond, Virginia 23219
(800) 552-3431
(804) 726-7000
http://www.dss.virginia.gov/division/index.cgi
citizen.services@dss.virginia.gov

Federal HealthCare.Gov Marketplace
Toll-Free: 1-800-318-2596
Website: HealthCare.gov

Virginia’s five largest cities in terms of population: Virginia Beach, Norfolk, Chesapeake, Richmond, and Newport News.